Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury

Abstract

Background Auditory complaints following mild traumatic brain injury are common, but few studies have addressed the role of auditory temporal processing in speech recognition complaints. Purpose In this study, deficits understanding speech in a background of speech noise following MTBI were evaluated with the goal of comparing the relative contributions of auditory and non-auditory factors. Research Design A matched-groups design was used in which a group of listeners with a history of MTBI were compared to a group matched in age and pure-tone thresholds, as well as a control group of young listeners with normal hearing. Study Sample Thirty-three listeners participated in the study, including thirteen in the MTBI group (mean age 46.7 years), eleven in the Matched group (mean age 49 years), and nine in the YNH group (mean age 20.8 years). Data Collection and Analysis Speech-in-noise deficits were evaluated using subjective measures as well as monaural word (WIN) and sentence (QuickSIN) tasks, and a binaural spatial release task. Performance on these measures was compared to psychophysical tasks evaluating monaural and binaural temporal fine structure tasks and spectral resolution. Cognitive measures of attention, processing speed, and working memory were evaluated as a possible difference between MTBI and Matched groups contributing to speech-in-noise deficits. Results A high proportion of listeners in the MTBI group reported difficulty understanding speech in noise (84%) compared to the Matched group (9.1%), and listeners who reported difficulty were more likely to have abnormal results on objective measures of speech in noise. No significant group differences were found between the MTBI and Matched listeners on any of the measures reported, but the number of abnormal tests differed across groups. Regression analysis revealed that a combination of auditory and auditory processing factors contributed to monaural speech-in-noise scores, but the benefit of spatial separation was related to a combination of working memory and peripheral auditory factors across all listeners in the study. Conclusions The results of this study are consistent with previous findings that a subset of listeners with MTBI have objective auditory deficits. Speech-in-noise performance was related to a combination of auditory and non-auditory factors, confirming the important role of audiology in MTBI rehabilitation. Further research is needed to evaluate the prevalence and causal relationship of auditory deficits following MTBI.

Portable Automated Rapid Testing (PART) for auditory assessment: Validation in a young adult normal-hearing population

“…Although a number of candidate tests have been developed and are relatively well studied in laboratory settings (e.g. Moore et al, 1987;Grose and Mamo, 2012;Bernstein et al, 2013;Gallun et al, 2014;Füllgrabe, Moore & Stone, 2015;Jakien et al, 2017;Hoover, Souza & Gallun, 2017;, very few of these tests have been translated into standard clinical practice. Those tests that have been translated into the clinic are generally only used by audiologists with expertise in APDs because the testing often requires specialized equipment or setup and a calibrated The psychophysical test battery evaluated here was designed to reflect a description of the central auditory system inspired by current research in psychoacoustics and auditory neuroscience (e.g., Stecker & Gallun, 2012;Bernstein et al, 2013;Depireux, Simon, Klein & Shamma, 2000).…”

The Role of Speech-Language Pathology in an Interdisciplinary Care Model for Persistent Symptomatology of Mild Traumatic Brain Injury

“…Decreased functioning in noisy environments has been found post-mTBI in adults exposed to blast and non-military causes. 32,33 Auditory processing disorder (APD), a condition in which the integration and interpretation of sound becomes disordered, is estimated to be as high as 85 to 89% in certain populations post-mTBI, including sports and motor vehicle injuries. [34][35][36] Patients receive a hearing screening and complete the Functional Hearing Questionnaire 37 offering the patient's perspectives on their auditory information.…”

Speech in noise: hearing loss, neurocognitive disorders, aging, traumatic brain injury and more

“…SIN The authors note that in addition to a thorough auditory and communications need assessment, the role of the audiologist may include counseling and the provision of technology to facilitate greater participation regarding skills of daily living and participation in rehabilitation. 76 Gallun, Papesh, and Lewis 77 noted an advantage for younger and middle-aged people who experienced TBI, is their willingness and enthusiasm to embrace technological advantages. They note audiologists who have worked with blast exposure patients with normal and near normal hearing have successfully prescribed minimal gain hearing aids for these people, with and without FM systems.…”

“…74 These strategies can provide easier and more effective listening in difficult listening situations (where social interaction takes place) such as restaurants, cafes or at a family dinner at home, and are often characterized by annoying, distracting and elevated noise levels. [75][76][77][78][79]…”